“The Washington Post is reporting that the federal government is in talks to take over the Oregon health exchange. This news comes after many failed attempts at launching state-based exchanges, with more than 25% of the state based exchange executive directors having resigned, and multiple states losing CIOs, and COOs for poor performance as a result. However, this may be just the first shoe to drop as many state-based exchanges do not have good sustainability plans in place to support themselves going forward. This could be the first of many takeovers of exchanges, and certainly will not be the last bailout of one.”

“The day that many health policy wonks have been waiting for has come: Obamacare’s first open–enrollment period has officially ended on April 15, 2014. Wasting little time, the Department of Health and Human Services (HHS) has released the last of its first–year enrollment reports. The update from HHS contains some good news, and some not–so–good news. Overall, it appears highly unlikely that the healthcare law will collapse.”

“The race for people to #GetCovered through Obamacare’s state and federal health insurance exchanges has officially crossed the wire. In its sixth and final enrollment report released late last week, the Department of Health and Human Services disclosed that a total of 8 million individuals have signed up for an Obamacare compliant plan within the individual health insurance market.”

“Yesterday Massachusetts officials announced plans to default to Healthcare.gov, but also announced a quixotic sprint to try first try to rebuild the entire site in five months with a brand new, no-bid taxpayer-paid contract to health care software developer hCentive. This move comes eight months into open enrollment, after launching the worst performing exchange in the country, spending most of the $180 million from Washington and announcing that original contractor CGI would be fired—even though it is still working on the project. The announcement should leave taxpayers and policymakers scratching their heads and wondering about the lack of accountability, government management and procurement.”

“Remember Cash for Clunkers? That program gave car buyers rebates of up to $4,500 if they traded in less fuel-efficient vehicles for new vehicles with better gas mileage. But because most of the vehicles garnering such rebates would have sold anyway, taxpayers ended up paying about $24,000 per additional car sale these incentives produced.[1] Obamacare appears to be in a fierce race to beat Cash for Clunkers to become the poster child for mismanagement of federal taxpayer resources.”

“Despite Obamacare’s strong national enrollment numbers, several states are at risk for big premium hikes.

Each state is its own insurance market, and they had wildly different experiences during Obamacare’s first open-enrollment window. So although nationwide statistics are important for judging the law’s political success, the substantive tests for the law’s future mostly lie with the states—and some of them aren’t looking so hot.”

“The first suggested Obamacare premium prices for 2015 don’t look so scary, but a few states could soon be in for some nasty sticker shock.

Health insurers that are still processing enrollments from Obamacare signups are at the same time setting their premiums for 2015 individual policies—and setting the stage for more debate about the Affordable Care Act.”

“Massachusetts pioneered universal health care in 2006. Under then-Governor Mitt Romney, it was the first state to guarantee access to insurance — and drove its uninsured rate down to just 4 percent.

Which makes it baffling that Massachusetts did arguably the worst of any state in implementing Obamacare. Like a handful of ardent Obamacare supporters in other states, Massachusetts officials tried to pull off an ambitious launch — and failed badly.”

“A few months into Obamacare’s coverage expansion, there’s been plenty of debate about where the millions of newly insured have obtained coverage — whether through the law’s exchanges, directly from an insurer, through expanded Medicaid or through an employer. The health-care law’s immediate impact is a little more clear in hospitals, which are starting to report who’s coming through their doors during the first months of expanded coverage under the Affordable Care Act.”

“An insurer in Washington state selling plans under the Affordable Care Act is proposing to lower customers’ health premiums next year in what appears to be one of the first such decreases proposed for 2015.”